Gallbladder Cancer

Definition

Gallbladder cancer is a disease in which cancer cells grow in the gallbladder. This is a relatively rare form of cancer. The gallbladder is a small pear-shaped organ that sits beneath the liver. It stores bile until it is needed by the digestive system. Bile is a greenish-yellow digestive fluid produced by the liver that helps in digesting fat.

Causes

Cancer occurs when cells in the body divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues. Cancer that has invaded nearby tissues can then spread to other parts of the body.

It is not clear exactly what causes these problems in the cells, but is probably a combination of genetics and environment.

Risk Factors

Gallbladder cancer is more common in women and those of Native American or Hispanic descent. Other factors that may increase your chance of gallbladder cancer include:

Gallstones
or chronic inflammation of the gallbladder, including calcification of the gallbladder (porcelain gallbladder)

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. Gallbladder cancer is often hard to diagnose because there are no early symptoms. Gallbladder cancer is usually discovered incidentally during abdominal surgery for other reasons.

Tests may include:

Blood tests

Biopsy
—The removal of a sample of tissue for testing. This is usually an open surgery.

Imaging tests evaluate the gallbladder and surrounding structures. These may include:

The physical exam combined with all of your test results, will help to determine the stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, gallbladder cancer is staged from I-IV. Stage I is a very localized cancer, while stage IV indicates a spread to other parts of the body.

Treatment

Treatment depends on the stage of the cancer. For advanced cancers, treatment is done only to help relieve symptoms. Treatments include:

Surgery

Surgical removal of the gallbladder is called
cholecystectomy. Part of the liver and lymph nodes near the gallbladder may also be removed. In some cases, surgery is done to relieve symptoms by opening obstructed bile ducts. ERCP may also be used for this purpose.

Radiation Therapy

Radiation therapy
uses radiation to kill cancer cells and shrink tumors. Radiation is most often administered from a source outside the body.

Chemotherapy

Chemotherapy
is the use of drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells. Chemotherapy is not considered curative for gallbladder cancer, but may relieve symptoms in some.

Combined Modality Therapy (CMT)

CMT is a term gaining popularity and meaning several treatments at once or in succession. Although it has not been shown that chemo- and radiation therapy at the same time are better than radiation therapy alone in the treatment of gallbladder cancer, CMT is better with many other kinds of cancers.

Prevention

There are no curent guidelines to prevent gallbladder cancer because the cause is unknown. If you have problems with gallstones, talk to your doctor about the risks and benefits of removing the gallbladder.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Tumors of the gallbladder and bile ducts. The Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/tumors-of-the-gallbladder-and-bile-ducts. Updated November 2013. Accessed November 26, 2014.